Military called to help as virus taxes hospital staffs

A medical worker administers a shot of Russia’s Sputnik V coronavirus vaccine Friday at a vaccination center in Moscow.
(AP/Pavel Golovkin)
A medical worker administers a shot of Russia’s Sputnik V coronavirus vaccine Friday at a vaccination center in Moscow. (AP/Pavel Golovkin)


More U.S. states desperate to defend against covid-19 are calling on the National Guard and other military personnel to assist virus-weary medical staffs at hospitals and other care centers.

After warning for months that vaccinations would ward off disaster, officials see the U.S. sailing toward a holiday crisis.

People who got sick after refusing to get vaccinated are overwhelming hospitals in certain states, especially in the Northeast and the Upper Midwest. New York announced a statewide indoor mask order, effective Monday and lasting five weeks through the holiday season.

"We're entering a time of uncertainty, and we could either plateau here or our cases could get out of control," Gov. Kathy Hochul warned Friday.

In Michigan, health director Elizabeth Hertel said, "I want to be absolutely clear: You are risking serious illness, hospitalization and even death" without a vaccination.

The seven-day rolling average for daily new cases in the U.S. rose over the past two weeks to 117,677 by Thursday, compared with 84,756 on Thanksgiving Day, according to Johns Hopkins University. The number of people hospitalized with covid-19 has soared to about 54,000 on average, according to the Centers for Disease Control and Prevention.




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Meanwhile, the country is approaching a new milestone of 800,000 covid-19 deaths. The total topped 796,000 Friday, according to Johns Hopkins.

More than 200 million Americans, or about 60% of the population, are now fully vaccinated, but that leaves millions who are not.

In Maine, which hit a pandemic high this week with nearly 400 patients in hospitals, as many as 75 members of the National Guard were being summoned to try to keep people out of critical care with monoclonal antibodies and to perform other nonclinical tasks.

Maine has one of the highest vaccination rates in the country -- 73% -- but that rate lags in many of the state's rural pockets.

The New York National Guard said it had deployed 120 Army medics and Air Force medical technicians to 12 nursing homes and long-term-care facilities to relieve fatigued staffs.

Dr. Paolo Marciano, chief medical officer at Beaumont Hospital in Dearborn, Mich., said it was a "tremendous lifeline" to get assistance from the Defense Department, which has more than 60 nurses, doctors and respiratory therapists assigned to the state.

"It allowed us to be able to care for the covid patients and at the same time still maintain the level of care that cancer patients require or people with chronic illnesses," Marciano said. "Where we are today is really just keeping our heads above water."

Michigan is sending more ventilators to hospitals and asking for even more from the national stockpile. Infection rates and hospitalizations are at record levels. The first case of the omicron variant was confirmed Thursday in the Grand Rapids area.




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The largest hospital system in Indiana enlisted the National Guard for support this week as the number of patients in that state more than doubled in the past month. The state's hospitalizations are now higher than Indiana's summer surge that peaked in September and are approaching the pandemic peak reached in late 2020.

'DESPERATE SHAPE'

Cases and hospital admissions are rising amid a season of family gatherings.

Most victims have shunned inoculations. The situation is especially dire in the chilly Northeastern states, but doctors in many places report a grimly repetitive cycle of admission, intensive care and death. There are shortages of beds and staffing to care for the suffering.

"We're in desperate shape," said Brian Weis, chief medical officer at Northwest Texas Healthcare System in Amarillo, the state's worst hot spot.

In 12 states and the nation's capital, the seven-day average of admissions with confirmed covid-19 has climbed at least 50% from two weeks earlier, according to U.S. Department of Health and Human Services data. The areas with the largest percentage upticks were Connecticut, New Jersey, Washington, D.C., Vermont and Rhode Island.

In the most recent CDC data, from September, unvaccinated people had about 14 times the risk of dying from covid-19 after adjusting for age -- a major factor in covid outcomes.

In some states in the Midwest and Northeast, hospitalizations are mirroring last year's seasonal pattern, said Pinar Karaca-Mandic, one of the leaders of the Covid-19 Hospitalization Tracking Project at the University of Minnesota.

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"The winter coming, people are being more indoors," she said. During last year's surge, "everyone was unvaccinated," Karaca-Mandic said. While most Americans are inoculated now, they're also isolating less than last year.

Officials continue to push shots. In Boston, Mayor Michelle Wu sent out news of getting her booster at City Hall on Thursday. The city is adding vaccination clinics, including at schools, and colleges around the region have begun telling students that boosters will be required. New Hampshire held a "Booster Blitz" on Friday at sites across the state.

But Karaca-Mandic said the wild card is the new variant: "We just don't know what will happen with omicron."

As the world has turned its focus to the omicron strain, which spreads quickly but may be no more deadly, cases caused by the delta variant have continued to mount in the U.S. The waves emerge and recede at different times in different regions, and recent hot spots such as Montana and Colorado are now seeing improvement.

Still, Colorado had just 518 acute-care beds available Thursday, said Scott Bookman, the state's covid incident commander. "We have a long way to go before our hospitals empty out," he said in a news briefing.

Even in places coping well, a sense of foreboding prevails. California has seen relatively steady infection rates in recent weeks, with hospitalizations around the levels they were in July before delta took hold. But the most populous state had 11 confirmed omicron cases as of Wednesday, which "presumes we'll see dozens more in the next days, hundreds more in the next weeks, thousands more" after that, Gov. Gavin Newsom said on ABC television.

In Amarillo, Texas, elective surgeries have been canceled and emergency rooms are jammed with virus patients who must wait as long as five days for hospital beds, Weis said in a phone interview. Regional hospital officials have petitioned the state for additional staffing, "but there's little hope they can come through," he said.

In Connecticut, which has one of the highest vaccination rates in the U.S., 576 people were hospitalized as of Dec. 8, and 77% of them were unvaccinated, state data show.

New Jersey's average daily hospital admissions reached a seven-day average of 206, up 78% from two weeks earlier. Even so, at this time a year ago, the pace of admissions was well over twice that.

"The overwhelming majority of our new cases, new hospitalizations and new deaths, sadly, are from among the unvaccinated," Gov. Phil Murphy said this week.

Geisinger Health System, which has nine hospitals in northeastern and central Pennsylvania, is overcapacity and turning away patients, said Gerald Maloney, chief medical officer for hospital services.

"People are tired," Maloney said in an interview. "It's worse already than it was a year ago, and it may get even worse."

In Michigan, hospitals are hitting a critical point. The state's 22,883 inpatient beds are more than 85% occupied, said John Karasinski, spokesman for the Michigan Health and Hospital Association.

"The situation is dire and compounded by several factors," Karasinski said in a phone interview. "The covid-19 surge is stressing hospitals, their workforce and capacity. There are ongoing staffing shortages. It existed before the pandemic and has gotten worse during the pandemic."

The Department of Defense sent three teams of 22 medical professionals to help, each in a different part of the state.

Illinois had 3,178 hospitalizations as of Wednesday, the highest since January, according to the state health department. Six of the state's 11 regions had 20 or fewer intensive-care beds available.

Thanksgiving weekend is a likely driver of the rebound, said Arien Herrmann, hospital coordinating-center manager for the state's southern-most counties.

"People traveling, visiting friends and family, having gatherings created an opportunity for community spread," Herrmann said in a phone interview. "It'll be the same thing going into Christmas and then New Year's. This is keeping me up at night."

INDOOR MASKS RULE

Facing a cold-weather surge in infections, New York's Hochul announced Friday that masks will be required in all indoor public places unless the businesses or venues implement vaccine requirements.

She said the decision was based on a rising number of cases and hospitalizations. The mandate applies to both patrons and staff, and will be in effect from Monday to Jan. 15, after which the state will reevaluate.

New York joins several states with similar indoor mask mandates, including Washington, Oregon, Illinois, New Mexico, Nevada and Hawaii.

Hochul's announcement was cheered by some fellow Democrats and a union representing retail and grocery workers, even as Republicans called it an overreach and an unnecessary burden on businesses.

Violators could face civil and criminal penalties, including a maximum fine of $1,000. Hochul said local health departments will enforce the requirements.

Niagara County Legislature chairwoman Becky Wydysh, a Republican, said local officials don't believe a mandate is the best use of resources. The county will take an "educate to cooperate approach" to enforcement, Wydysh said in a statement.

News of the mandate was welcome at Lake Placid Christmas Co., a shop on Main Street in the tourist-friendly Adirondack village.

"Our employees all wear masks, but we stopped requiring all of our customers to wear masks because it was too hard to enforce," said manager Scott Delahant. "Quite frankly, I got sick of arguing with people."

SOURCE OF VIRUS

Nearly two years into the pandemic, the origin of the virus remains shrouded in mystery.

Most scientists believe it emerged in the wild and jumped from bats to humans, either directly or through another animal. Others theorize it escaped from a Chinese lab.

Now, with the global death toll nearing 5.3 million on the second anniversary of the earliest human cases, a growing chorus of scientists is trying to keep the focus on what they regard as the more plausible "zoonotic," or animal-to-human, theory, in the hope that what's learned will help humankind fend off new viruses and variants.

"The lab-leak scenario gets a lot of attention, you know, on places like Twitter," but "there's no evidence that this virus was in a lab," said University of Utah scientist Stephen Goldstein, who with 20 others wrote an article in the journal Cell in August laying out evidence for animal origin.

Michael Worobey, an evolutionary biologist at the University of Arizona who contributed to the article, said his own and others' research has made him even more confident about the animal hypothesis, which is "just way more supported by the data."

Last month, Worobey published a timeline linking the first known human case to the Huanan Seafood Wholesale Market in Wuhan, China, where live animals were sold.

"The lab leak idea is almost certainly a huge distraction that's taking focus away from what actually happened," he said.

Scientists said in the Cell paper that SARS-CoV-2, which causes covid-19, is the ninth documented coronavirus to infect humans. All previous ones originated in animals.

Many researchers believe wild animals were intermediate hosts for SARS-CoV-2, meaning they were infected with a bat coronavirus that then evolved. Scientists have been looking for the exact bat coronavirus involved, and in September identified three viruses in bats in Laos more similar to SARS-CoV-2 than any known viruses.

Worobey suspects raccoon dogs were the intermediate host. The fox-like mammals are susceptible to coronaviruses and were being sold live at the Huanan market, he said.

Many types of animals have gotten infected. Most got the virus from people, according to the CDC, which says humans can spread it to animals during close contact but that the risk of animals transmitting it to people is low.

Another fear, however, is that animals could be sources for new viral variants. Some wonder if the omicron variant began this way.

"Around the world, we might have animals potentially incubating these variants even if we get (covid-19) under control in humans," said David O'Connor, a virology expert at the University of Wisconsin-Madison. "We're probably not going to do a big giraffe immunization program any time soon."

Information for this article was contributed by Ed White, David Eggert, Carolyn Thompson, Karen Matthews, Marina Villeneuve, Michael Hill and Laura Ungar of The Associated Press; and by Jonathan Levin, David Welch, John Tozzi, Vincent Del Giudice, Joe Carroll, Kara Wetzel, Elizabeth Campbell and Carey Goldberg of Bloomberg News (WPNS).


  photo  A woman walks out of a free covid-19 testing site Friday in Chicago. As of Wednesday, Illinois had 3,178 hospitalizations, the highest since January, according to the state health department. Six of the state’s 11 regions had 20 or fewer intensive-care beds available. (AP/Nam Y. Huh)
 
 


  photo  “We’re entering a time of uncertainty, and we could either plateau here or our cases could get out of control,” New York Gov. Kathy Hochul warned Friday in New York City in announcing a statewide indoor mask order. (AP/Mary Altaffer)
 
 



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